What are Gap Plans?

Group Supplemental Health plans, also known as Gap Plans, cover out-of-pocket expenses that may be excluded from High Deductible Health Plans (HDHPs).* Gap plans are paired with an employer’s base medical insurance plan, based on their employees’ deductibles. Because the price of group health insurance continues to increase, Gap plans are a promising solution to certain employers which are too small to self-insure, or those worried about compromising employee benefits for savings.   

*For 2020, the IRS defines a high deductible health plan as any plan with a deductible of at least $1,400 for an individual or $2,800 for a family.


What does Gap Health Insurance Cover?

A medical gap insurance plan provides coverage for a subscriber’s Explanation of Benefits (EOB) up to a maximum amount. In most cases, subscribers must meet a deductible prior to plan reimbursement. While Gap Health Insurance covers most of the same expenses as your major medical plan, it does not cover office fees, outpatient prescription drugs, vision/dental, or plan copayments.


The Bottom Line

Gap plans are becoming increasingly popular for covering high medical deductibles that once left subscribers feeling helpless. Medical bills are known to cause financial strain on the average individual, but with supplemental protection, subscribers can find peace of mind. As an employer, the holistic wellbeing of your employees should rank high on your list of priorities. Maintaining a healthy workforce will not only benefit employees, but also your bottom line.

If you think a gap plan may be beneficial to your company, contact the experts at BMPG for analysis and expertise. We will help you compare gap plans from various carriers and weigh which option will best supplement your major medical insurance.